UNDERSTANDING

PHLEBOTOMY
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Phlebotomy
§  Defined as an incision or a puncture into a vein in order to obtain
blood

§  One of the oldest medical procedures, dating back to the early

Egyptians and was termed as “bloodletting”.
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§  Hippocrates believed that disease was caused by an
excess of body fluids, including blood, bile, and
phlegm, and that removal of the excess would cause
the body to return to or maintain a healthy state, and
Evolution of the first-line treatment before all others: bloodletting.
Phlebotomy §  Techniques for bloodletting:
-suction cup devices with lancets
-application of blood-sucking worms, called “leeches,”
-barber surgery, in which blood from an incision
produced by the barber’s razor was collected in a
bleeding bowl.

§  Bloodletting is now called “therapeutic phlebotomy”

and is used as a treatment for only a small number
of blood disorders such as hemochromatosis.
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Bloodletting-Set of a Barber-Surgeon
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BARBERS’ POLE
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Suction cup device

Scarificator
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Bloodletting through suction devices

 Bloodletting
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through
leeches

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Evolution of PHLEBOTOMY AT PRESENT:

Phlebotomy
primary role of phlebotomy is the collection of
blood samples for laboratory analysis to diagnose
and monitor medical conditions.

Because of the increased number and complexity

of laboratory tests, phlebotomy has become a
specialized area of clinical laboratory practice and
has brought about the creation of the job title
“phlebotomist.”
 DUTIES OF THE PHLEBOTOMIST IN TODAY’S HEALTHCARE
SETTING

§  A phlebotomist is a person trained to obtain blood samples primarily by venipuncture and microtechniques.
§  Major traditional duties and responsibilities of the phlebotomist include:
1.  Correct identification and preparation of the patient before sample collection
2.  Collection of the appropriate amount of blood by venipuncture or dermal puncture for the specified tests
3.  Selection of the appropriate sample containers for the specified tests
4.  Correct labeling of all samples with the required information
5.  Appropriate transportation of samples back to the laboratory in a timely manner
6.  Effective interaction with patients and hospital personnel
7.  Processing of samples for delivery to the appropriate laboratory departments
8.  Performance of computer operations and record-keeping pertaining to phlebotomy
9.  Observation of all safety regulations, quality control checks, and preventive maintenance procedures
10.  Attendance at continuing education programs
11.  Monitoring the quality of samples collected on the units
12.  Performing and monitoring point-of-care testing (POCT)
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Traits That Form The Professional
Image of the Phlebotomist

§  Dependable, cooperative, committed

§  Compassionate, courteous, respectful

§  Integrity, honesty, competence

§  Organized, responsible, flexible

§  Appearance

§  Communication
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Dependable, Cooperative, Committed

§  Laboratory testing begins with sample collection and relies on the

phlebotomist to report to work whenever scheduled and on time..
Failure to appear or arriving late puts additional pressure on the
staff members present.

§  Be willing to demonstrate your commitment to your job and your

cooperation to assist fellow employees. A committed
phlebotomist attends staff meetings, reads pertinent memoranda,
and observes notices placed on bulletin boards or in newsletters.
 Compassionate, Courteous, Respectful
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§  Phlebotomists deal with sick, anxious, and frightened patients every day. They must be
sensitive to their needs, understand a patient’s concern about a possible diagnosis or just
the fear of a needle, and take the time to reassure each patient. A smile and a cheerful
tone of voice are simple techniques that can put a patient more at ease.

§  Courteous phlebotomists introduce themselves to the patients before they approach them.
This also aids in identifying the patient as you can then ask them to state their name in the
same conversation. Phlebotomists must also understand and respect the cultural diversity
of their patients.

§  Cultural diversity includes not only language but also religious beliefs, customs, and
values. Do not expect every patient to respond to you in the same way and do not force
your mannerisms and approach on them.
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Honesty, Integrity, Competence

§  The phlebotomist should never hesitate to admit a mistake, because a

misidentified patient or mislabeled sample can be critical to patient safety.
Patient confidentiality must be protected, and patient information is never
discussed with anyone who does not have a professional need to know it.

§  Phlebotomists must demonstrate competence in the procedures they are

trained to perform. However, overconfidence in one’s abilities can result in
serious errors. Never perform a procedure that you have not been trained to
perform. When faced with this situation do not hesitate to ask for assistance
from someone more experienced.
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Organized, Responsible, Flexible

§  Phlebotomists need to organize their collection equipment and maintain well-

stocked collection tray or station. They must also organize and prioritize their
work.
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Appearance

§  Phlebotomists should be neat and should have clean-looking

appearance that portrays a professional attitude to the patient.
Remember first impressions are lasting impressions often made
within 30 seconds and the phlebotomist represents the entire
laboratory staff.
 General Appearance Guidelines

1.  Clothing and lab coats must be clean and unwrinkled. Clothing worn under the laboratory coat
should meet institutional requirements. Lab coats must be completely buttoned and completely
cover clothing.
2.  Shoes must be clean, polished, closed toed, and skid-proof.
3.  If jewelry is worn, it must be conservative. Dangling jewelry including earrings can be grabbed by a
patient or become tangled in bedside equipment. Many institutions do not permit facial piercings and
tattoos; if present, they must be completely covered. Makeup must also be conservatively applied.
4.  Perfume and cologne are usually not recommended or must be kept to a minimum. Many persons
are allergic to certain fragrances. Remember the phlebotomist works in close contact with the
patient and the smell of perfume can be particularly disturbing to a sick person.
5.  Hair including facial hair must be clean, neat, and trimmed. Long hair must be neatly pulled back.
6.  Personal hygiene is extremely important because of close patient contact, and careful attention
should be paid to bathing and the use of deodorants and mouthwashes.
7.  Fingernails must be clean and short. Based on the Centers for Disease Control and Prevention
(CDC) Handwashing Guidelines, artificial nail extenders are not allowed.
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Communication Skills

§  Good communication skills are needed for the phlebotomist to

function as the liaison between the laboratory and the patients,
their family and visitors, and other health-care personnel.

§  The three components of communication:

-  verbal skills

-  listening skills

-  nonverbal skills or body language

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Communication Skills

§  Verbal Skills

-  to introduce themselves, explain the procedure, reassure the

patient, and help assure the patient that the procedure is being
competently performed.

-  Barriers to verbal communication that must be considered include

physical handicaps such as hearing impairment; patient emotions;
and the level of patient education, age, and language proficiency.
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§  Listening Skills

-  Looking directly and attentively at the patient

-  Encouraging the patient to express feelings, anxieties, and concerns

-  Allowing the patient time to describe why he or she is concerned

-  Providing feedback to the patient through appropriate responses

-  Encouraging patient communication by asking questions

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Communication Skills

§  Nonverbal Skills

-  include facial expressions, posture, and eye contact.

-  If you walk briskly into the room, smile, and look directly at the
patient while talking, you demonstrate positive body language. This
makes patients feel that they are important and that you care about
them and your work

-  Allowing patients to maintain their zone of comfort (space) is

important in phlebotomy even though you must be close to them to
collect the sample.
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Telephone Skills

§  The phlebotomy department frequently acts as a type of

switchboard for the rest of the laboratory because of its location
in the central processing area.

§  This is a prime example of the phlebotomist’s role as a liaison

for the laboratory, and poor telephone skills affect the image of
the laboratory.
§  To observe the rules of proper telephone etiquette:
- Answer the phone promptly and politely, stating the name of the department and
your name.
-  Always check for an emergency before putting someone on hold, and return to
calls that are on hold as soon as possible.
-  Keep writing materials beside the phone to record information such as the location
of emergency blood collections, requests for test results, and numbers for
returning calls.
-  Make every attempt to help callers, and if you cannot help them, transfer them to
another person or department that can.
-  Provide accurate and consistent information by keeping current with laboratory
policies, looking up information published in department manuals, or asking a
supervisor.
-  Speak clearly and make sure you understand what the caller is asking and that he
or she understands the information you are providing.